Traditionalism and Its Relationship to Disease Risk and Protective Behaviors of Women Living on the Hopi Reservation

Abstract

The fundamental aim of this study was to identify factors crucial for the development of effective cancer prevention programs for American Indian (AI) populations. Toward that end, we developed an instrument to assess the influence of traditionalism on health risks such as smoking, consumption, and obesity. A population-based survey was conducted among 559 randomly selected women living on the Hopi reservation aged 18 years and older, from July through December 1993. To construct a traditionalism score, we conducted focus groups in the community. A multidimensional approach was adopted by assessing three dimensions of native culture: language usage; cultural participation, or participation in such activities as Hopi ceremonies; and percentage of life spent off-reservation. A mean score of the three dimensions was computed for each respondent. High levels of traditionalism were significantly associated with disease protective behaviors, such as practicing traditional Hopi activities to keep healthy (OR = 3.07), and significantly inversely associated with disease risk factors such as smoking (OR = 0.26) and obesity (OR = 0.60) independent of age, marital status, and education. As these data provide a strong rationale for the promotion of traditions in public health programs aimed at decreasing rates of chronic disease among AI women, we conclude this paper with a discussion of the importance of traditionalism and how it might be accurately assessed.

Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004

“…In addition, cultural hesitance to access Western medicine for nonacute health problems, infrequent provider recommendations to get screened, insufficient health coverage, inability to afford Medicare or insurance copays, and transportation difficulties are factors commonly cited as cancer screening barriers by AI/AN individuals. 46,[64][65][66] Alaska, although it has the highest AI/AN population CRC rates, had the highest proportion of cases detected in early stages. Among IHS regions, Alaska has been the most proactive toward CRC screening.…”

“…44 For AI/ ANs, this tends to select those with more income, higher levels of education, and less traditional ways of life, all of which have been associated with higher rates of screening participation. 8,45,46 In addition, cultural factors, including a reluctance to trust outsiders, modesty, and hesitancy to discuss one's health, may bias BRFSS prevalence estimates further for AI/ANs.…”

Prostate cancer incidence among American Indian and Alaska Native men, US, 1999-2004

“…Several studies, involving only AI/AN females, have examined relations between cultural beliefs and practices, or ''traditionality,'' and receipt of breast and/or cervical cancer screening. [50][51][52][53][54][55] Although the results of these and other studies were generally mixed, future research regarding the influences of traditionality on receipt of cancer screening tests (eg, for colorectal cancer) or seeking care when symptoms develop should include AI/AN men.…”

Constructing a Health and Social Indicator Framework for Indigenous Community Health Research

“…Pointing to the narrow definitions of health and well-being guiding established indicator systems, much research has called for the need to rectify gaps in knowledge from the use of existing indicators. Specifically, a large number of critiques have espoused the development and application of new indicators reflecting more culturally appropriate, holistic views of health and well-being for Indigenous populations (Durie, 1994;Thompson and Gifford, 2000;Auer and Andersson, 2001;Wilson and Rosenberg, 2002;Coe et al, 2004;Donna Cona, 2004). Indeed, several projects in Canada, Australia, and New Zealand have already engaged in processes to create and validate new community-level measures for specific use in health and social programmes and research in Indigenous communities (Institute of the Environment/ University of Ottawa et al, 2002; Steering Committee for the Review of Government Service Provision, 2003;Walker, et al, 2003;Giles and Findlay, 2004;Karjala et al, 2004).…”